Korean Circ J.  2021 Aug;51(8):681-693. 10.4070/kcj.2021.0029.

Economic Burden of Heart Failure in Asian Countries with Different Healthcare Systems

  • 1Division of Cardiology, Department of Internal Medicine, Ramathibodi Hospital, Bangkok, Thailand
  • 2Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan ROC
  • 3Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 4Department of Cardiology, Sarawak General Hospital, Kuching, Malaysia
  • 5Department of Cardiology, Queen Elizabeth Hospital 2, Sabah, Malaysia
  • 6Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea


Background and Objectives
Heart failure (HF) poses substantial economic burden, primarily driven by high hospitalization and mortality rates. This study aimed to understand the economic burden of HF in 4 Asian countries under varying healthcare systems.
This was a non-interventional, retrospective study conducted in South Korea, Taiwan, Thailand and Malaysia through medical chart review. Eligible patients included those who had either ≥1 hospitalization or ≥2 outpatient visits from January 1st to December 31st, 2014, and at least one year of follow-up. Resource use and direct healthcare costs (adjusted to 2015 USD) of HF were assessed. HF costs for subgroups stratified by age and sex were assessed.
A total of 568 patients were recruited from South Korea (n=200), Taiwan (n=200), Thailand (n=100) and Malaysia (n=68). The proportion of patients hospitalized ranged from 20.0% to 93.5% (South Korea 20.0%, Thailand 49.0%, Malaysia 70.6%, and Taiwan 93.5%). The overall annual HF cost per patient was $2,357, $4,513, $3,513 and $1,443 in South Korea, Taiwan, Thailand, and Malaysia, respectively; hospitalized HF care costs were $10,714, $4,790, $7,181 and $1,776, respectively. The length of stay was more than 12.2 days except in Malaysia. No specific trend was observed in subgroup analysis.
In Asia, HF poses significant economic burden and hospitalization has emerged as the major cost driver among healthcare costs. A streamlined treatment strategy reducing hospitalization rate can minimize the economic burden.


Heart failure; Hospitalization; Health care costs; Length of stay; Cost of illness
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